<? global $lg, $FullUrl, $notice; ?>

<div class="form-main">
  <div class="form-header">&nbsp;</div>
  <div class="form-content">
    <div style="padding:0 25px; display:block; overflow:hidden;">
    	<div class="title-form"><span>Gift Code</span></div>
      <form action="<?=$FullUrl?>/index.php?do=player&act=giftcodesm" method="post" name="reg">
        <label style="width:370px !important; font-weight:bold; text-align:center;">Gift Code sẽ được gửi qua email của bạn.</label>       
        <br/>
        <?php
        	$_SESSION['captcha'] = mt_rand(10000, 99999);
        ?>
        <div style="display:inline-block; width:350px; float:left;margin-left:130px;"> <img src="lib/Captcha/PHP-CAPTCHA/php_captcha.php"></div>
        <label>Kiểm tra</label>
        <input type="text" name="number_captcha" id="code" value="" onfocus="if(this.value=='Mã kiểm tra') this.value=''" onblur="if(this.value=='') this.value='Mã kiểm tra'" value="Mã kiểm tra"/>
        <?=isset($notice)?$notice:'';$notice = ''; ?>
        <br/>
        <input value="Nhận Gift Code" name=reg type="submit" class="btn-form sbm">
      </form>
    </div>
  </div>
  <div class="form-bottom">&nbsp;</div>
</div>
<?php Template::UserControlTPL('Menu-GD'); ?>